Abstract
BackgroundPregnancy is a unique physiological condition with the cellular immune functions compromised at some extents to allow the mature of growing fetus. Whether pregnancy may influence the replication of hepatitis B virus (HBV) is less studied. The present study aimed to investigate the influence of pregnancy on the replication of HBV and expression of viral antigens by comparing the levels of HBV DNA and viral antigens in pregnant and non-pregnant women.MethodsA total of 727 HBsAg-positive serum samples, collected from 214 pregnant women and 513 non-pregnant women of childbearing age, were included. Based on the pregnancy status, subjects were divided into four groups: nulliparous (n = 158), pregnant (n = 214), 7–12 months postpartum (n = 170), and 2–5 years postpartum (n = 185). The levels of hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg) were quantitatively measured with microparticle enzyme immunoassay. HBV DNA levels were detected by fluorescent real-time PCR.ResultsThe median ages of four groups were 25.0, 25.3, 26.2 and 29.3 years, respectively (p < 0.01). HBeAg-positive proportions were 34.2, 33.6, 35.3 and 29.2%, respectively (p = 0.624). HBV DNA levels in HBeAg-positive women were higher than those in HBeAg-negative women (7.88 vs 2.62 log IU/ml, p < 0.001). HBV DNA levels in the four groups with positive HBeAg were 7.8, 7.7, 8.0 and 8.0 log IU/ml, respectively (p = 0.057), while HBsAg titers were 4.4, 4.5, 4.6 and 4.8 log IU/ml (p = 0.086) and HBeAg titers were 3.1, 3.0, 3.1 and 3.0 log S/CO (p = 0.198). In the four groups with negative HBeAg, HBV DNA levels were 2.3, 2.6, 2.5 and 2.8 log IU/ml, respectively (p = 0.085), while HBsAg titers were 3.1, 3.3, 3.3 and 3.0 log IU/ml (p = 0.06).ConclusionsSerum levels of HBV DNA and viral antigens showed no significant changes in nulliparous, pregnant, and postpartum women, regardless of the HBeAg status. The results indicate that pregnancy has little influence on the replication of HBV and the expression of viral antigens.
Highlights
Pregnancy is a unique physiological condition with the cellular immune functions compromised at some extents to allow the mature of growing fetus
Before the availability of hepatitis B immunoglobulin (HBIG) and hepatitis B vaccine, 10–30% and 70–90% of the children born to hepatitis B virus (HBV) carrier mothers with negative hepatitis B e antigen (HBeAg) and to HBeAg-positive carrier mothers had been chronically infected with HBV respectively
The data in the present study show that the levels of HBV DNA and viral antigens in the pregnant women were comparable with those in nulliparas, puerperants 7– 12 months and 2–5 years postpartum, respectively, indicating that the replication of HBV and expression of viral antigens during pregnancy are not increased in spite of the presence of immune tolerance during pregnancy
Summary
Pregnancy is a unique physiological condition with the cellular immune functions compromised at some extents to allow the mature of growing fetus. Whether pregnancy may influence the replication of hepatitis B virus (HBV) is less studied. The present study aimed to investigate the influence of pregnancy on the replication of HBV and expression of viral antigens by comparing the levels of HBV DNA and viral antigens in pregnant and non-pregnant women. Transmission of HBV from carrier mothers to their children is an important cause of chronic infection in hepatitis B endemic areas. Measures for preventing mother-to-child transmission of HBV, combined use of HBIG and hepatitis B vaccine [2, 3], have been implemented in most countries. The influence of pregnancy on the replication of HBV in pregnant women infected with HBV is less studied. A survey in Massachusetts General Hospital, Boston, USA, showed a high frequency of inadequate care of mothers with chronic hepatitis B post-pregnancy [13]
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